Provider Demographics
NPI:1427202720
Name:BRIGA, JANIS INESIS (PHD)
Entity Type:Individual
Prefix:
First Name:JANIS
Middle Name:INESIS
Last Name:BRIGA
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:JOHN
Other - Middle Name:I
Other - Last Name:BRIGA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2400 TAMARACK AVENUE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SOUTH WINDSOR
Mailing Address - State:CT
Mailing Address - Zip Code:06074
Mailing Address - Country:US
Mailing Address - Phone:860-432-1199
Mailing Address - Fax:860-432-1152
Practice Address - Street 1:2400 TAMARACK AVENUE
Practice Address - Street 2:SUITE 201
Practice Address - City:SOUTH WINDSOR
Practice Address - State:CT
Practice Address - Zip Code:06074
Practice Address - Country:US
Practice Address - Phone:860-432-1199
Practice Address - Fax:860-432-1152
Is Sole Proprietor?:No
Enumeration Date:2008-11-13
Last Update Date:2013-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001562103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist